title: Improving family satisfaction and participation in decision making in an intensive care unit.
abstract: Background Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together. Objectives To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families. Methods A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm. Results Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation. Conclusions Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together.
authors.forename: Meredith
authors.initials: M
authors.lastname: Huffines
authors.forename: Karen L
authors.initials: KL
authors.lastname: Johnson
authors.forename: Linda L
authors.initials: LL
authors.lastname: Smitz Naranjo
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Lissauer
authors.forename: Marmie Ann-Michelle
authors.initials: MA
authors.lastname: Fishel
authors.forename: Susan M
authors.initials: SM
authors.lastname: D'Angelo Howes
authors.forename: Diane
authors.initials: D
authors.lastname: Pannullo
authors.forename: Mindy
authors.initials: M
authors.lastname: Ralls
authors.forename: Ruth
authors.initials: R
authors.lastname: Smith
mesh_terms: D000465:Algorithms; D003142:Communication; D003422:Critical Care / Q000379:methods; D003657:Decision Making; D005190:Family; D006801:Humans; D007362:Intensive Care Units; D010549:Personal Satisfaction; D011368:Professional-Family Relations